# Planning a Multi-Level Intervention to Reduce Substance Use Stigma in HIV Prevention and Care

> **NIH NIH R34** · WAYNE STATE UNIVERSITY · 2022 · $232,141

## Abstract

SUMMARY ABSTRACT
Both substance use disorders (SUDs) and HIV are subject to stigma, namely, the process by which an attribute
is deemed deeply discrediting and prone to prejudice and discrimination. Stigma toward SUDs and HIV arises
from multiple sources, including policies or individuals who carry out policies (“structural stigma”) and health
professionals (“provider-based stigma”). Stigma from health professionals experienced or anticipated by people
with SUDs can create barriers to accessing high-quality health services. For people with SUDs who need HIV
prevention or care, the added stigma of HIV may compound substance use-related stigma to enhance social
barriers to healthcare. However, few studies have examined the role of substance use stigma in HIV healthcare
contexts, or how to intervene on substance use stigma in this doubly-sensitive area of healthcare. Extant studies
on substance use stigma in other healthcare contexts found that educational interventions incorporating critical
reflection techniques and opportunities for contact with people who use drugs may significantly reduce provider-
based stigma. An even greater limitation is that provider-based stigma intervention studies fall short of practical
application: they largely focus on attitudinal outcomes among professionals, but do not measure the effects of
policies or how stigma interventions affect healthcare utilization or patient health outcomes. For HIV prevention
and care contexts to improve healthcare quality and outcomes among people with SUDs, interventions are
needed to reduce provider-based and structural stigma perennially attached to substance use. Our goal is to
adapt and refine a multi-level stigma intervention that leverages professional education and organizational policy
to address structural drivers of stigma and the stigmatizing professional attitudes and behaviors that determine
patient care and health. To achieve this goal, this planning project will work with federally qualified health centers
(FQHCs) to address three Specific Aims: 1) Create a substance use curriculum for HIV prevention and care
contexts that pilot testing demonstrates significantly improves knowledge, attitudes, and planned actions related
to professional stigma towards people who use drugs; 2) Use qualitative interviews with FQHC administrators
and personnel to identify organizational policies that improve conditions of professional decision-making and
may enhance the effects of professional education on stigma reduction; and 3) Develop, optimize, and finalize a
trial design and protocol that is intended to test how the multi-level SUD stigma intervention influences
intermediate outcomes related to SUDs and professional and patient stigma, as well as principal HIV outcomes
related to prevention and care. This project will use community-engaged research methods with FQHCs to
develop a multi-level stigma intervention and trial protocol that seeks to test whether combining educational and
or...

## Key facts

- **NIH application ID:** 10492447
- **Project number:** 5R34DA053758-02
- **Recipient organization:** WAYNE STATE UNIVERSITY
- **Principal Investigator:** Mark K Greenwald
- **Activity code:** R34 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $232,141
- **Award type:** 5
- **Project period:** 2021-09-30 → 2024-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10492447

## Citation

> US National Institutes of Health, RePORTER application 10492447, Planning a Multi-Level Intervention to Reduce Substance Use Stigma in HIV Prevention and Care (5R34DA053758-02). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10492447. Licensed CC0.

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